Later On

A blog written for those whose interests more or less match mine.

Ideology vs. Reality

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As we’ve repeatedly seen, in general it’s no contest: People will ignore blatant and obvious facts in order to keep their ideological framework intact. Example (non-political, from Wikipedia): “In 1912 the meteorologist Alfred Wegener amply described what he called continental drift, expanded in his 1915 book The Origin of Continents and Oceans[26].” That began the battle over his theory. He died while still fighting stubborn and determined opposition, though the theory is now considered true and indeed even obvious.

In the social sphere, ideology holds an even stronger sway. For example, StopTheDrugWar.org has a recent note by Philip Smith:

Treating intractable heroin addicts with a pharmaceutical version of their drug is more cost-effective than providing them with methadone, a common opioid substitute, a study published Monday in the Canadian Medical Association Journal suggests.

The study analyzed data from the North American Opiate Medication Initiative (NAOMI ), a 2005-2008 study that compared the use of diacetylmorphine (heroin) and methadone in street addicts. In the NAOMI study, researchers selected 250 subjects in Vancouver and Montreal who had been strung out for at least five years and had twice previously failed on methadone maintenance. Participants were randomly chosen to take either heroin or methadone.

Researchers in this study examined the cost-effectiveness of the two approaches in one-year, five-year, 10-year increments, as well over the lifetimes of the users. The study found that those using methadone generated an average lifetime social cost of $1.14 million, while those using heroin had a cost of $1.1 million, a difference of about $40,000 per user. An estimated 60,000 to 90,000 Canadians are addicted to heroin or other opioids.

“If you are on treatment, you’re basically well-behaved,” principal investigator Aslam Anis, a health economist at the University of British Columbia told the Canadian Press Monday. “When you’re not taking treatment, for instance when you relapse, you’re doing all kinds of bad things, criminal activity, getting into jail. The cost benefit is through an indirect effect,” said Anis, through fewer robberies and other crimes, which have an adverse impact on victims and drive up criminal justice system costs.

“People who take (medical) heroin are retained on the treatment for longer periods of time and they have shorter periods of time when they relapse,” Anis said. “And when you add it all up, you find that you’ve actually saved money.”

“Methadone can be a very effective medication for some people, but it doesn’t work for everybody with heroin addiction,” said coauthor Dr. Martin Schechter, an epidemiologist at UBC’s School of Population and Public Health. “And there is a subset of folks who go in and out of treatment and ultimately end up back using street heroin. They would be unlikely to be attracted into yet another methadone program,” he said.

“But giving them injections of medically prescribed heroin in a clinic setting staffed by doctors, nurses and counselors gets them back into the health-care system. It also cuts the risk of infection with hepatitis C and HIV from needle-sharing. So diacetylmorphine is a medically prescribed heroin that we show in the study was more likely to keep people in treatment. And we know that keeping people in treatment is a very important predictor of success.”

No matter what this or any other study finds, the Conservative Canadian government is opposed to harm reduction measures, such as safe injection sites and heroin maintenance therapies. Still, said Schecter, the government needs to face reality. . .

Continue reading. Notice the interesting tidbit that the government actually opposes harm reduction: the government is actually on record on the side of increased harm, rather than lessened harm. That’s what ideology will do to you.

UPDATE: I should, in fairness, point out that only sporadically is the government on the side of more harm (as when the US government wanted to spray paraquat on marijuana plants in hopes that those smoking the marijuana later would die painfully—an initiative finally stopped over strong protests from the Drug Warriors). Generally speaking, while the government opposes harm reduction, it doesn’t necessarily want to increase the harm potential. It believes that, miraculously, the amount of harm it’s now doing is just the right amount.

Written by LeisureGuy

15 March 2012 at 10:01 am

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